Two Physical Activity Measures: Paffenbarger Physical Activity Questionnaire Versus Aerobics Center Longitudinal Study as Predictors of Adult-Onset Type 2 Diabetes in a Follow-Up Study

Abstract

Purpose: To compare 2 self-report methods of measuring weekly minutes of physical activity based on the Aerobics Center Longitudinal Study (ACLS) questionnaire and question 6 of the Paffenbarger Physical Activity Questionnaire (PPAQ) to determine the better predictor of adult-onset type 2 diabetes mellitus (T2DM). Design: An observational, prospective study. Setting: Survey data from the Adventist Health Study-2 (AHS-2) collected between 2002 and 2006 (baseline) and the Psychosocial Manifestations of Religion Sub-Study (PsyMRS), an AHS-2 subset collected 1 to 4 years later. Patients: Nine thousand eight hundred seventy-three male and female participants aged 23 to 106 years (mean, 63 years). Three hundred eighty participants reported adult-onset T2DM at follow-up. Measures: Question 6 from the PPAQ and a question adopted from the ACLS were assessed at baseline. Incident diabetes was defined as participants who reported receiving treatment for adult-onset T2DM in the last 12 months in the PsyMRS and not at baseline. Analysis: Multivariate logistic regression analyses controlled for age, gender, ethnicity, education, body mass index (BMI), diet, and sedentary activity. Each exposure variable was compared to nonexercisers. Results: The PPAQ (odds ratio [OR]: 0.998; 95% confidence interval [CI]: 0.997-1.000) and the ACLS (OR: 0.999; 95% CI: 0.998-1.001) exhibited similar likelihood of predicting incident adult-onset T2DM in a healthy, mixed-gender population when controlling for several confounders. Conclusions: The demonstrative nomenclature of the PPAQ may be more effectual in capturing physically active individuals than the ACLS notwithstanding generalizability and response bias limitations.